Individual provider Active NPI

Alan Samuel Boulos, M.D.

  • Neurological Surgery Physician
  • Albany, NY
National Provider Identifier
1821090747
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
216291-1 Issued in NY
Practice address
47 New Scotland Ave
Albany, NY 12208-3412
Phone
(518) 262-5088
Fax
(518) 262-5400
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 216291-1 NY Primary

Addresses

Primary practice location

47 New Scotland Ave
Albany, NY 12208-3412

Mailing address

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5088

Other identifiers 1

IdentifierTypeStateIssuer
02310474MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006000042 NY Practitioner - Neurosurgery 2163614413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Albany Medical College of Union University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
216291-1NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821090747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5088",
            "fax_number": "518-262-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5088",
            "fax_number": "518-262-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "ALAN",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "216291-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02310474",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.